‘Whole patient’ care urged by UMMS psychologist

New book examines the treatment of people with physical and mental illnesses

By Lisa M. Larson

UMass Medical School Communications

October 26, 2011

Sherry Pagoto, PhD

Doctors focused on caring for the whole patient have a new tool for treating men and women who suffer from both physical and psychological illnesses, thanks to a new book edited by clinical psychologist Sherry Pagoto, PhD, associate professor of medicine.

“We see a high rate of psychological disorders in patients with medical illnesses,” said Dr. Pagoto, “and you can only treat the whole patient if you think in terms of what is going on with both their physical and mental health.”

While reams of literature exist for treatment of individual disorders, little has been written on the treatment of many co-occurring physical and mental illnesses, Pagoto said.

Psychological Co-morbidities of Physical Illness: A Behavioral Medicine Perspective is the first book to provide an in-depth examination of the psychological co-morbidities of physical illness, a close look at the factors involved in each condition and implications for treatment. It is also, Pagoto says, a call to action for more research into the treatment of these co-occurring illnesses.

The book is organized according to physical conditions, with chapters on obesity, diabetes, HIV/AIDS, cardiovascular disease, cancer and others, each of which includes the most prevalent psychological disorders to occur with those illnesses. It addresses the mechanisms that explain the connection between the physical and psychological conditions, research related to both and treatment considerations. Gaps in research are also identified.

Each chapter is written by an expert, with help from contributing colleagues, and is a compilation of the most recent research on the particular illness and co-occurring psychological disorder. Many of the contributors are UMMS faculty members from the Division of Preventive and Behavioral Medicine and the Department of Psychiatry.

Pagoto wrote the first chapter, which is on obesity and the psychological disorders that are often experienced by people with obesity.

“Not only are people with various psychological disorders disproportionately affected by obesity, but obesity appears to increase risk for various psychological disorders,” Pagoto writes.

For example, she notes, people with schizophrenia have a high rate of obesity, often stemming from medication side effects and reduced access to care. Their weight gain becomes a serious health issue in itself, often leading to cardiovascular problems and diabetes. But little research has been done on treating their obesity.

“People with schizophrenia have a life span averaging 25 years shorter than the average,” she said. “What other group of people has a life expectancy 25 years less than average but so little research has been done to understand why and what to do about it ?”

Pagoto examines the problem in the book, presents what studies have been published, provides guidance for both medical and mental health providers, and identifies areas for future research. Obesity is one of 11 major illnesses addressed in the book, published by Springer.